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Antidiuretic hormone or arginine vasopressin, is a peptide hormone released by the posterior pituitary in response to low plasma volume or increased plasma osmotic pressure. The hormone increases reabsorption of water at the kidney and increases systemic vascular resistance. When ADH is released in an unregulated fashion the circulating plasma becomes diluted, resulting in hyponatremia. This is called syndrome of inappropriate antidiuretic hormone secretion.

We are into a topic where students tend to have once again, problems with organization, but likely have done the entire time the more organized you are with your thoughts, the more methodically you can go through the material and the more number of times you do this, then it becomes part of your reflex and this brings us to the concentration of urine. And with this lecture series, we will be getting into issues of ADH either, too much or too little. At first, let us say that you have a patient that is deprived of water. The best thing to do before you go through all of these chronological order, you want to pay attention or predict as to what you can expect in your patient. Once you have done that, then you take a look at the chronology and all of it will make sense. You deprive your patient of water. What does that mean to you? It means that your plasma osmolarity is going to increase, doesn't it? Once your plasma osmolarity increases, then the osmoreceptors by the hypothalamus will be triggered and you will be releasing your ADH. That ADH then runs down to the collecting duct that works to then insert these aquaporins via V2 receptors so that you can reabsorb that water, so that you can bring the plasma osmolarity back down to normal, right? So in essence, it is exactly what this illustration is showing you. Deprivation of water, increased plasma osmolarity. What happens next? Operative word, stimulation of your osmoreceptors. Next, you increase ADH. That ADH will then run down to the collecting duct, they'll work through V2 receptors. It will then insert the aquaporins so that you reabsorb water purely. As you do so, it then causes the urine osmolarity...